Kimura Motoya, Niwa Jun-Ichi, Doyu Manabu
Department of Neurology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute 480-1195, Japan.
Vaccines (Basel). 2022 Jun 11;10(6):935. doi: 10.3390/vaccines10060935.
Rhabdomyolysis is a well-known clinical syndrome of muscle injury. Rhabdomyolysis following coronavirus disease 2019 (COVID-19) vaccination has recently been reported. The patients' weakness gradually subsided and did not recur. Rhabdomyolysis associated with COVID-19 vaccination has not been assessed by repeated magnetic resonance imaging (MRI) within a short time. We report a rare case of an older woman who developed recurring weakness with rhabdomyolysis after COVID-19 vaccination. A 76-year-old woman presented with myalgia 2 days after receiving a third dose of the COVID-19 vaccine. A physical examination showed weakness of the bilateral iliopsoas muscles. Her creatine kinase concentration was 9816 U/L. MRI showed hyperintensity of multiple limb muscles. She was treated with intravenous normal saline. Her symptoms disappeared within 3 days. However, MRI on day 4 of hospitalization showed exacerbation of the hyperintensity in the left upper limb muscles. On day 5 of hospitalization, weakness of the left supraspinatus and deltoid muscles appeared. MRI on day 8 of hospitalization showed attenuation of the hyperintensity in all muscles. Her weakness and elevated creatine kinase concentration disappeared by day 10. Repeated MRI over a short time may be useful to predict potential weakness and monitor the course of COVID-19 vaccine-induced rhabdomyolysis.
横纹肌溶解症是一种众所周知的肌肉损伤临床综合征。最近有报告称2019冠状病毒病（COVID-19）疫苗接种后出现横纹肌溶解症。患者的肌无力逐渐消退且未复发。与COVID-19疫苗接种相关的横纹肌溶解症尚未在短时间内通过重复磁共振成像（MRI）进行评估。我们报告了一例罕见病例，一名老年女性在接种COVID-19疫苗后出现复发性肌无力并伴有横纹肌溶解症。一名76岁女性在接种第三剂COVID-19疫苗后2天出现肌痛。体格检查显示双侧髂腰肌无力。她的肌酸激酶浓度为9816 U/L。MRI显示多块肢体肌肉呈高信号。她接受了静脉输注生理盐水治疗。她的症状在3天内消失。然而，住院第4天的MRI显示左上肢肌肉高信号加重。住院第5天，出现左冈上肌和三角肌无力。住院第8天的MRI显示所有肌肉的高信号减弱。到第10天，她的肌无力和肌酸激酶浓度升高消失。短时间内重复进行MRI可能有助于预测潜在的肌无力并监测COVID-19疫苗诱导的横纹肌溶解症病程。
